The purpose of this study is to determine if the addition of alvimopan to our care process
model for colon resection patients will decrease length of stay. The care process model is a
combination of optimal IV fluid management, early feeding, early ambulation, patient
education, and pain management.

Clinical Details

Official title: A Randomized, Double Blind, Placebo Controlled Study to Study Intermountain Healthcare's Enhanced Recovery Protocol for Colon Surgery With and Without Alvimopan Use

Detailed description:
Narcotic pain medicines bind mu-opioid receptors in the bowel and delay the return of normal
function. Alvimopan is a peripherally acting mu-opioid receptor antagonist that blocks
mu-opioid receptors in the gastrointestinal (GI) tract but does not compromise central
nervous system-mediated opioid-based analgesia. Length of stay (LOS) is an important
surrogate measure of quality after colon surgery and the most common reason for prolonged
LOS after abdominal surgery is delayed GI recovery (postoperative ileus).

The Food and Drug Administration (FDA) has approved alvimopan (dosed preoperatively and
twice daily postoperatively for up to 15 in-hospital doses) for the acceleration of upper
and lower GI recovery after partial bowel resection with primary anastomosis. In the 5 phase
III alvimopan efficacy trials, a simple standardized accelerated postoperative care pathway
was used rather than a comprehensive, multidisciplinary colon surgery (MDCS) care process
model that is used by Intermountain Healthcare. In the most recently completed alvimopan
phase III trial, the mean postoperative LOS was 5. 2 days whereas the mean LOS at
Intermountain Healthcare is 4. 4 days without the addition of alvimopan to the MDCS care
process model.

This trial will investigate if the addition of alvimopan to the Intermountain Healthcare
MDCS care process can decrease LOS compared with the MDCS care process plus placebo.